J Neurol Neurosurg Psychiatry 74:1361-1362 doi:10.1136/jnnp.74.10.1361
  • Chronic fatigue syndrome
  • Editorial commentary

Enteroviruses in chronic fatigue syndrome: “now you see them, now you don’t”

  1. M C Dalakas
  1. Neuromuscular Diseases Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Building 10, Room 4N248, 10 Center Dr. MSC 1382, MD 20892-1382, USA
  1. Correspondence to:
 Dr M C Dalakas ;

    Can enteroviruses infect human muscle and cause persistent infection that affects only the metabolic machinery of the cells without muscle destruction?

    In the paper by Lane et al(see pp 1382–1386)1 an association was found between abnormal exercise lactate response and enterovirus sequences in the muscle of some patients with chronic fatigue syndrome (CFS). The paper rekindles the old saga of enteroviruses, muscle inflammation, and fatigue.

    CFS remains an elusive entity. When all known factors causing fatigue are excluded, a number of patients have organic disease. Because some CFS patients have impaired muscle energy metabolism,2 the cause of fatigue may not be “in their head” but “in their muscle”. Now, Lane et al propose …

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